Precipitation trends and their relationship with El Niño Oceanic Index. The case of the Mixteca Region, Mexico

[EN] The occurrence of droughts is a permanent concern in arid and semi-arid zones, especially for socially vulnerable ones such as the Mixteca Region in Mexico, a condition that can be aggravated as climate change scenarios predicts. The general circulation models do not allow forecasting precipitation conditions at regional scales, so it is necessary to study local climate behavior and trends. Determining the relationship between local climate and large-scale phenomena, such as El Niño / La Niña events, is relevant to set up prevention measures. This article analyzes the precipitation trends in the Mixteca Region of Mexico, determines the presence of a statistically significant trend in observed decrease in precipitation, and analyzes the relationship between precipitation conditions in the zone and the Ocean Niño Index. It is shown that there is a statistically significant trend of decreasing precipitation, and it is found that there is a correlation between the El Niño Oceanic Index and the conditions of extreme precipitation -humidity or drought- in the region.[ES] La ocurrencia de sequías es una preocupación constante en zonas áridas y semiáridas, especialmente cuando se trata de regiones socialmente vulnerables como es el caso de la Región Mixteca en México, condición que puede agravarse según se anticipa de los escenarios de cambio climático. Los modelos de circulación general no permiten prever las condiciones de precipitación en escalas regionales, por lo que se hace necesario el estudio de las tendencias y comportamientos climáticos locales. Determinar la relación entre el clima local y fenómenos de gran escala, como los eventos El Niño/La Niña, es de relevancia para establecer medidas de prevención. En este artículo se analiza la tendencia de la precipitación en la región Mixteca de México, se determina la presencia de una tendencia estadísticamente significativa a la disminución en la precipitación, y se analiza la relación entre las condiciones de precipitación en la zona y el Índice Oceánico El Niño. Se muestra que existe una tendencia estadísticamente significativa de disminución de la precipitación, y se encuentra que existe una correlación entre el índice Oceánico El Niño y las condiciones de precipitación extrema -humedad o sequía- en la región.Martínez-Austria, PF.; Díaz-Jiménez, D. (2018). Tendencias de la precipitación y su relación con el Índice Oceánico El Niño. El caso de la Región Mixteca, México. Ingeniería del Agua. 22(1):1-14. doi:10.4995/ia.2018.7779SWORD114221Ahmad, I., Tang, D., Wang, T.F., Wang, M., Wagan, B. 2015. Precipitation trends over time using Mann-Kendall and Spearman's Rho tests in Swat River Basin, Pakistan. Advances in Meteorology. 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Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably